Forsell Claes, Aberg Jonas, Szabó Zoltán
Department of Cardiothoracic and Vacular Surgery and Cardiothoracic Anesthesia, Linköping University Hospital, Sweden; ; Division of Cardiovascular Medicine, Department of Medical and Health Sciences, Linköping University, Linköping, Sweden.
Int J Biomed Sci. 2013 Sep;9(3):181-4.
Severe lower limb ischemia TASC IIB/III with sensory and motor neurologic deficiencies leads to prolonged hospital care, amputation, and death in 20-70 % of cases. We present our first clinical experience of the use of preoperative topical hypothermia to improve muscular viability in these patients. Two hours after onset of symptoms, six 4-liter plastic bags were filled with snow and packed against the ischemic leg which was protected from frost injury by a layer of towels. After surgical revascularization four hours later muscular and neural functions in the leg were completely restored. A maximum serum myoglobin of 6500 ng/L (median 12000 ng/L in similar but untreated patients) postoperatively decreased to 1400 ng/L after 27 hours.
伴有感觉和运动神经功能缺陷的严重下肢缺血（TASC IIB/III型）会导致20%至70%的病例出现住院时间延长、截肢以及死亡。我们展示了术前局部低温治疗用于改善这些患者肌肉活力的首例临床经验。症状出现两小时后，六个4升的塑料袋装满雪，紧贴缺血的腿部放置，腿部通过一层毛巾保护以防冻伤。四小时后进行手术血运重建，术后腿部肌肉和神经功能完全恢复。术后血清肌红蛋白最高值为6500 ng/L（类似但未接受治疗的患者中位数为12000 ng/L），27小时后降至1400 ng/L。
